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Research letter
Trends in the mortality of intra-abdominal infections in adults over 25 years in the USA, 1999–2021
  1. Yi Liu1,
  2. Jamil S Samaan2,
  3. Youssef M Essanaa3,
  4. Fan Lv4,
  5. Fanpu Ji1,5,6,7,8,
  6. Kamran Samakar9,
  7. Yee Hui Yeo2
  1. 1 Department of Infectious Diseases, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
  2. 2 Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
  3. 3 University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
  4. 4 School of Mathematics and Statistics, Xi'an Jiaotong University, Xi'an, China
  5. 5 National and Local Joint Engineering Research Center of Biodiagnosis and Biotherapy, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
  6. 6 Shaanxi Clinical Medical Research Center of Infectious Diseases, Xi'an, China
  7. 7 Key Laboratory of Surgical Critical Care and Life Support (Xi'an Jiaotong University), Ministry of Education of China, Xi'an, China
  8. 8 Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education of China, Xi'an, China
  9. 9 Division of Upper GI and General Surgery, Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
  1. Correspondence to Professor Kamran Samakar, Division of Upper GI and General Surgery, Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, California, USA; Kamran.Samakar{at}med.usc.edu; Dr Yee Hui Yeo, Karsh Division of Gastroenterology and Hepatology, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA; yeehui.yeo{at}cshs.org

https://doi.org/10.1136/emermed-2023-213478

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    Intra-abdominal infections are the second most common source of severe sepsis and successful treatment relies on early intervention and appropriate resources.1–3 The COVID-19 pandemic has disrupted the global healthcare system as evidenced by a national study in England showing reduced admissions and higher 90-day mortality for common acute surgical conditions.4 5 We examined intra-abdominal infection-related mortality trends from 1999 to 2021, which encompasses the COVID-19 pandemic.

    Using the National Vital Statistics System (NVSS) database (1999–2021), which registers more than 99% of deaths in the USA, we obtained decedents with intra-abdominal infection, defined as deaths related to acute cholecystitis, acute appendicitis, Clostridioides difficile colitis, diverticulitis or pyelonephritis (multiple causes were possible). Age-standardised mortality rates (ASMR) per 100 000 population were calculated using the 2010 US Census as the standard population. Joinpoint Regression Program (V.4.9.0.0) was performed to evaluate ASMR trends overall and stratified by age groups: young age (25–44), middle age (45–64) and the elderly (≥65) (online supplemental file 1). Forecast analysis was conducted to predict annual ASMR in 2020 and 2021 from intra-abdominal infections based …

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    Footnotes

    • Handling editor Darryl Wood

    • YL and JSS contributed equally.

    • Contributors Concept and design: JSS, YL, FJ, YHY. Acquisition and analysis of data: YL, YHY. Interpretation of data: JSS, YL, YME, FL, FJ, KS, YHY. Drafting of the manuscript: JSS, YME, YL. Critical revision of the manuscript for important intellectual content: JSS, YL, YME, FL, FJ, KS, YHY. Administrative, technical or material support: YL, FJ. Supervision: KS, YHY.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests FJ has received speaker fees from Gilead Sciences, MSD and Ascletis, in addition to consulting or advisory board fees from Gilead and MSD.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.